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Supplier Form
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Supplier Form
1. Personal Information
1. Personal Information
Name
Full Name / Contact Person (required)
Company Name
Company / Business Name (required)
Phone
*
Phone Number (WhatsApp preferred) (required)
Email Address
Email Address (required)
Confirm Email Address
2. Business Information
2. Business Information
Business Type
Business Type
Manufacturer
Wholesaler
Trader
Distributor
Other
Primary Product Category
Select Category
Textiles
Electronics
Agro / Food Products
Industrial Supplies
Construction Materials
Chemicals
Automotive
Other
3A. GST / Business ID / License No. (Optional)
GST / VAT / Sales Tax / Business ID (Optional)
Enter GSTIN, VAT number, Sales Tax ID, or any business license number (optional).
0 / 30
3B. Upload Business Card / Catalog (Optional)
Upload Business Card / Catalog (Optional)
Upload your business card or brief product catalog (optional).
Drag and Drop (or)
Choose Files
3C. Add Section Heading (optional, for clarity)
3. Verification & Consent
I confirm that the information provided is true, and I am interested in working with Das Verra.
*
I Agree
Submit Application
